In ED resuscitation patients, can Renal RI predict development of AKI?
Research type
Research Study
Full title
In emergency department patients requiring resuscitation room care, can Renal Resistive Index measurements predict the development of acute kidney injury?
IRAS ID
149795
Contact name
Heather Venables
Contact email
Sponsor organisation
University of Bath
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Acute kidney injury (AKI) is a dynamic, complex disorder characterised by rapid reduction in renal function over a period of < 48 hours. In the UK, AKI is seen in 13–18% of all patients admitted to hospital with a mortality rate of 20-30% (NICE 2013). With estimated costs to the NHS between £434 and £620 million per year, the financial impact of AKI exceeds that of breast cancer, lung cancer and skin cancers combined (ibid).
There are no known curative therapies for the progressive renal damage caused by AKI; therefore early detection and the development of preventive strategies are essential (NICE 2013).
Current methods of identifying patients at risk of AKI rely on monitoring of changes in serum creatinine level (sCr) which typically will rise 2-3 days after initial renal insult and on a fall in urine output over > 6 hours. However, both of these indicators are problematic in the Emergency Department (ED) as baseline sCr level is unknown and rapid decision making may be required.
Renal resistive index (RRI) is a simple, rapid and non-invasive ultrasound measurement that has been used in the assessment of native and transplanted kidneys for more than two decades. Recent studies in critical care suggest that RRI may be a helpful early indicator of AKI and risk of persistent renal damage. (Darmon 2011, Guinno et al 2013).
This prospective study will explore the feasibility of RRI measurement in patients admitted to the ED resuscitation room, the additional training requirements of ED doctors to perform RRI measurement and the clinical usefulness of RRI compared to existing tests of AKI risk on admission.
If feasible in this context, RRI may facilitate early implementation of a renal protective care bundle to prevent progressive renal damage in these patients.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
15/EM/0349
Date of REC Opinion
22 Oct 2015
REC opinion
Further Information Favourable Opinion